Successful use of olorofim for the treatment of Lomentospora prolificans knee tendonitis, synovitis, and concomitant osteomyelitis in an immunocompetent child

Lomentospora prolificans is a filamentous mold that can cause infections in both immunocompromised and immunocompetent individuals. Infection can be either focal or disseminated, often acquired via inhalation or direct conidia inoculation (A. Konsoula, C. Tsioutis, I. Markaki, M. Papadakis, A.P. Agouridis, N. Spernovasilis. Microorganisms 10:1317, 2022, https://doi.org/10.3390/microorganisms10071317). This pathogen is challenging to treat due to its high MICs to available antifungals. We present a case of an 8-year-old previously healthy female who developed L. prolificans knee tendonitis and synovitis with patellar osteomyelitis after a flat patio stone laceration in Southern California, who ultimately was treated with the novel antifungal, olorofim.